Home » Misc » Highest dosage of effexor

Highest dosage of effexor


Effexor® (Venlafaxine) Dosage Guide | hims

Medically reviewed by Katelyn Hagerty, FNP

Written by Our Editorial Team

Last updated 7/14/2021

Venlafaxine, commonly sold under the brand names Effexor® and Effexor XR®, is an antidepressant that’s used to treat depression and several anxiety disorders.

Effexor and Effexor XR belong to a class of medications called serotonin-norepinephrine reuptake inhibitors, or SNRIs. Like other antidepressants, it works by increasing the levels of certain chemicals, called neurotransmitters, in your brain. 

Effexor and Effexor XR come in tablet and capsule form and are prescribed in several different dosages, ranging from 37.5mg to 225mg per day.

If you’re prescribed Effexor or its extended release version, Effexor Xr, it’s important to follow any instructions provided by your healthcare provider and use your medication as directed. 

Below, we’ve explained what Effexor is and how it works within your body.

We’ve also listed the typical dosages of Effexor, Effexor XR and generic venlafaxine for depression, generalized anxiety disorder and other conditions. 

Finally, we’ve listed the most common side effects you should be aware of before using Effexor, Effexor XR or generic venlafaxine. 

What Is Effexor?

Effexor is a common brand name for the medication venlafaxine, an antidepressant that’s part of a class of medications called serotonin-norepinephrine reuptake inhibitors, or SNRIs.

The FDA has approved Effexor and Effexor XR as medications for major depressive disorder (MDD, or simply depression), generalized anxiety disorder, social anxiety disorder and panic disorder.

Some healthcare providers may also prescribe Effexor or Effexor XR to treat hot flashes, migraines, attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD) and several forms of pain.

As an SNRI, both Effexor and Effexor XR work by increasing the levels of serotonin, norepinephrine and dopamine in your brain.

These chemicals, known as neurotransmitters, are responsible for regulating certain aspects of your mood, thoughts and behavior.

For example, serotonin is involved in regulating feelings of happiness and anxiety. It also helps to control your body’s sleep-wake cycle.

Norepinephrine plays a role in your sleep-wake cycle. It’s also responsible for helping you to respond to stress, managing your mood and allowing you to concentrate on specific tasks.

Low levels of these neurotransmitters, specifically serotonin, are associated with a higher risk of developing depression, anxiety and obsessive-compulsive disorder.

Our full guide to how antidepressants work goes into more detail about how Effexor, Effexor XR and similar medications work to control the symptoms of depression. 

online counseling

the best way to try counseling

Effexor Dosages

Effexor is prescribed to treat several mental health conditions. It’s available as an oral capsule and as an oral tablet. In tablet form, it’s available in immediate-release and extended-release (Effexor XR) forms.

Effexor Dosage for Depression

As a treatment for depression, Effexor is typically prescribed at a starting daily dose of 37.5mg to 75mg per day. Your healthcare provider may increase this to 75mg per day, or to a maximum dose of 225mg per day.

Some clinical trials show that people with severe depression may respond to higher doses of the immediate-release version of Effexor.

The extended-release capsules of Effexor, Effexor XR, should be taken one time per day. If you’re prescribed the immediate-release version of Effexor, you may need to take your medication in two or three divided doses.

Make sure to follow the instructions provided by your healthcare provider and use Effexor and/or Effexor XR only as directed.

Effexor Dosage for Generalized Anxiety Disorder

As a treatment for generalized anxiety disorder, Effexor XR and extended-release venlafaxine are typically prescribed at a starting daily dose of 75mg per day, taken in a single dose.

In certain cases, your healthcare provider may recommend starting treatment at 37.5 per day, then increasing your dosage after four to seven days.

For generalized anxiety disorder, the maximum dosage of Effexor XR and generic venlafaxine is 225mg per day.

Effexor XR Dosage for Social Anxiety Disorder

As a treatment for social anxiety disorder, Effexor XR and generic extended-release venlafaxine are prescribed at a dose of 75mg per day, taken in a single dose. 

Effexor XR Dosage for Panic Disorder

As a treatment for panic disorder, Effexor XR and extended-release venlafaxine are prescribed at a starting dose of 37.5mg per day. Dose increases to 75mg per day following seven days of treatment are also possible

Dose increases may also be necessary if Effexor XR or generic venlafaxine isn’t effective at controlling the symptoms of panic disorder. Currently, the maximum dosage of Effexor XR used for panic disorder is 225mg.

Effexor Side Effects & Interactions

Effexor and Effexor XR are widely-used medications that are safe and effective for most people. However, as with other antidepressants, they can cause adverse effects.

Common side effects of Effexor, Effexor XR and generic venlafaxine include:

  • Nausea

  • Somnolence (sleepiness)

  • Sweating

  • Dry mouth

  • Ejaculation problems (slow ejaculation and/or difficulty ejaculating)

  • Erectile dysfunction

  • Reduced level of interest in sex

  • Constipation

  • Anorexia

You may experience these side effects shortly after starting treatment with Effexor. Make sure to inform your healthcare provider if you have side effects that are severe or persistent.

You may also experience allergic reactions while using Effexor or Effexor XR. Allergic reactions to this medication include hives and rashes, shortness of breath or any other typical reaction symptoms. If you experience an allergic reaction while using Effexor or Effexor XR, contact your healthcare provider immediately.

Although uncommon, Effexor may cause other side effects and health issues, including elevated blood pressure, angle closure glaucoma, activation of mania/hypomania and an elevated risk of abnormal bleeding, which means you should speak to your healthcare provider if you have an underlying medical condition that may be worsened by an increase in heart rate, blood pressure, etc.

Our venlafaxine safety information page provides more information on using Effexor and generic venlafaxine safely.

Like other antidepressant drugs, Effexor and generic venlafaxine may interact with other medications, including other antidepressants.

When used with other serotonin drugs, venlafaxine can cause a dangerous, potentially life-threatening reaction called serotonin syndrome. 

Because of the potential risk of serotonin syndrome while using Effexor or Effexor XR, it’s extremely important to be open and transparent with your healthcare provider about what kinds of medications you currently use or have recently used.

Our guide to antidepressant side effects goes into more detail about potential side effects and interactions that can occur with Effexor and similar medications used in treating depressed patients. 

How to Use Effexor Effectively

Effexor is an easy, convenient medication to use. To get the best results from Effexor or generic venlafaxine, make sure to:

  • Use your medication as directed. Your healthcare provider will inform you about how much Effexor or generic venlafaxine to take daily. Make sure to follow their instructions and use your medication at the prescribed dosage.

  • Take Effexor two or three times per day, with food. The immediate-release version of Effexor should be taken two or three times each day. Take your medication with food at the times suggested by your healthcare provider.

  • Take Effexor XR one time per day. The extended-release capsules (XR) of Effexor only need to be taken one time per day. This form of Effexor can be taken in the morning or evening with food.

  • Store Effexor properly. Effexor should be stored in a room temperature space, out of reach of children. Do not store this medication in a bathroom or other overly damp or warm environment.

  • Wait six to eight weeks of treatment before assessing your results. It may take six to eight weeks before you experience any changes after you start treatment with Effexor. It’s important to continue using your medication, even if the effects aren’t immediately noticeable. You can find more information in our guide to how long it takes Effexor to work.

  • If you experience side effects, inform your healthcare provider. If you get severe or persistent side effects from Effexor, your healthcare provider may make dosage adjustments or prescribe a different medication.

  • Do not adjust your dosage or suddenly stop taking Effexor. Like many other antidepressants, Effexor can cause withdrawal symptoms if it’s stopped abruptly. Do not make dosage adjustments or stop taking Effexor without first talking to your healthcare provider. 

online psychiatrist prescriptions

talk to a psychiatry provider. it’s never been easier

In Conclusion

Effexor is one of a few common prescription drugs that are used to treat depression, generalized anxiety disorder(GAD) and several other mental health conditions.

Effexor and generic venlafaxine are generally prescribed at a dosage of 37.5 to 225mg per day, although this can vary depending on the specific condition for which this medication is used.

If you’re prescribed Effexor or generic venlafaxine, make sure to follow the instructions provided by your healthcare provider and use your medication as directed.

You can learn more about Effexor and other medications used in mental health treatment in our full list of antidepressants. 

7 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. EFFEXOR XR® (venlafaxine Extended-Release) Capsules. (2017, January). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020699s107lbl.pdf
  2. Gallagher, H.C., Gallagher, R.M., Butler, M., Buggy, D.J. & Henman, M.C. (2015, August). Venlafaxine for neuropathic pain in adults. Cochrane Database of Systematic Reviews. 2015 (8), CD011091. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6481532/
  3. Singh, D. & Saadabadi, A. (2020, November 3). Venlafaxine. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK535363/
  4. What is Serotonin? (2018, December). Retrieved from https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/serotonin
  5. Norepinephrine. (2019, September). Retrieved from https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/norepinephrine
  6. EFFEXOR - venlafaxine hydrochloride tablet. (2008, February). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/020151s051lbl.pdf
  7. Venlafaxine. (2017, December 15). Retrieved from https://medlineplus.gov/druginfo/meds/a694020.html

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Side Effects, Dosage, Uses, and More

Highlights for venlafaxine

  1. Venlafaxine oral tablet is only available as a generic drug. It comes in both an immediate-release and an extended-release form.
  2. Venlafaxine also comes as an extended-release oral capsule.
  3. Venlafaxine oral tablet is used to treat depression (immediate-release tablet and extended-release tablet). It’s also used to treat social anxiety disorder (extended-release tablet only).

FDA warning: Suicidal behavior warning

Other warnings

  • Serotonin syndrome warning: This drug may cause a possibly life threatening condition called serotonin syndrome. Symptoms of serotonin syndrome include:
    • hallucinations and delusions
    • agitation
    • coma
    • fast heart rate
    • changes in blood pressure
    • dizziness
    • loss of consciousness
    • seizures
    • shakiness
    • muscle tremor or stiff muscles
    • sweating
    • nausea
    • vomiting
  • High blood pressure warning: Venlafaxine may increase your blood pressure. Your doctor will likely make sure your blood pressure is normal before you start taking venlafaxine. They will check your blood pressure regularly during your treatment.
  • Increased bleeding warning: This drug may increase your risk for bleeding or bruising if used with aspirin, nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen, or the blood thinner warfarin. Talk with your doctor if you’re taking or planning to take any prescription or over-the-counter medications that increase the risk of bleeding.

Venlafaxine is a prescription drug. It comes as an oral tablet and an oral capsule.

Venlafaxine oral tablet comes in immediate-release and extended-release forms. Both forms are only available as generic drugs. Generic drugs usually cost less than brand-name drugs.

Why it’s used

Venlafaxine oral tablet is used to treat depression (immediate-release tablet and extended-release tablet). It’s also used to treat social anxiety disorder (extended-release tablet only).

Venlafaxine may be used as part of a combination therapy. This means you may need to take it with other medications to treat your condition.

How it works

Venlafaxine belongs to a class of antidepressant drugs called serotonin norepinephrine reuptake inhibitors (SNRIs). A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

SNRIs work by increasing the levels of substances called serotonin and norepinephrine in your brain. Having more serotonin and norepinephrine in your brain can improve your symptoms of depression and anxiety.

Venlafaxine oral tablet may cause drowsiness. It may also affect your ability to make decisions, think clearly, or react quickly. You should not drive, use heavy machinery, or do things that require you to be alert until you know you can function normally. Venlafaxine may also cause other side effects.

More common side effects

The more common side effects of venlafaxine can include:

  • unusual dreams
  • sexual problems, such as:
    • decreased interest in sex
    • impotence (not being able to get or keep an erection)
    • trouble having an orgasm
  • loss of appetite
  • constipation
  • nausea or vomiting
  • dry mouth
  • tiredness
  • trouble sleeping or change in sleep habits
  • yawning
  • tremor or shaking
  • dizziness
  • blurry vision
  • sweating
  • feeling anxious, nervous, or jittery
  • headache
  • increased heart rate

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Attempting suicide
  • Acting on dangerous impulses
  • Aggressive or violent behavior
  • Thoughts about suicide or dying
  • New or worsened depression
  • New or worsened anxiety or panic attacks
  • Agitation, restlessness, anger, or irritability
  • Trouble sleeping
  • Serotonin syndrome. Symptoms can include:
    • agitation
    • hallucinations (seeing or hearing something that isn’t there)
    • coma
    • changes in your mental status
    • coordination problems
    • muscle twitching or overactive reflexes
    • fast heart rate
    • high or low blood pressure
    • sweating
    • fever
    • nausea
    • vomiting
    • diarrhea
    • muscle stiffness
  • High blood pressure. Symptoms can include:
    • headache
    • chest pain
  • Mania. Symptoms can include:
    • greatly increased energy
    • severe trouble sleeping
    • racing thoughts
    • reckless behavior
    • unusually grand ideas
    • excessive happiness or irritability
    • talking more or faster than usual
  • Seizures
  • Eye problems. Symptoms can include:
    • eye pain
    • vision changes
    • enlarged pupils
    • swelling or redness in or around your eyes
  • Low sodium levels. Symptoms can include:
    • headache
    • weakness
    • feeling unsteady
    • confusion
    • problems concentrating
    • thinking or memory problems
  • Bruising easily
  • Frequent nosebleeds
  • Frequent bleeding from your gums while brushing your teeth or flossing
  • Dark, tar-like stool
  • Bleeding from wounds that’s hard to stop
  • Lung disease or pneumonia. Symptoms can include:
    • shortness of breath that gets worse
    • cough
    • chest discomfort

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Venlafaxine oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with venlafaxine are listed below.

Drugs you should not use with venlafaxine

Do not take these drugs with venlafaxine. When used with venlafaxine, these drugs can cause dangerous effects in your body. Examples of these drugs include:

  • Monoamine oxidase inhibitors (MAOIs), including linezolid and methylene blue. Unless directed by your doctor, do not start venlafaxine within 2 weeks of stopping an MAOI and do not take an MAOI within 7 days of stopping venlafaxine. Taking venlafaxine and an MAOI too close together in time may cause serious or life threatening side effects. These side effects can include high fever, uncontrolled muscle spasms, and stiff muscles. Other side effects can include sudden changes in your heart rate or blood pressure, confusion, and passing out.
  • Drugs for weight loss, such as phentermine. Using venlafaxine with drugs such as phentermine may lead to excessive weight loss, serotonin syndrome, and heart problems such as rapid heart rate and high blood pressure.

Interactions that increase your risk of side effects

Taking venlafaxine with certain medications raises your risk of side effects. Examples of these drugs include:

  • Cimetidine. Taking this drug with venlafaxine raises your risk of high blood pressure or liver disease. These risks are greater if you are a senior.
  • Haloperidol. Taking this drug with venlafaxine raises your risk of QT prolongation. This is a heart condition with symptoms such as dizziness and an irregular heart rhythm.
  • Warfarin. Taking this drug with venlafaxine raises your risk of bleeding. Your doctor will monitor you closely, especially when starting or stopping your venlafaxine therapy. Tell your doctor right away if you notice any abnormal bleeding or bruising.
  • Anti-inflammatory drugs such as aspirin, ibuprofen, naproxen, and ketoprofen. Taking any of these drugs with venlafaxine raises your risk of bleeding. Your doctor will monitor you closely, especially when starting or stopping your venlafaxine therapy. Tell your doctor right away if you notice any abnormal bleeding or bruising.
  • Drugs such as ritonavir, clarithromycin, or ketoconazole. Drugs such as ritonavir, clarithromycin, or ketoconazole can slow the breakdown of drugs in your body. If you take any of these drugs with venlafaxine, the amount of venlafaxine may build up in your body. This would increase your risk of side effects.
  • Drugs that cause drowsiness, such as zolpidem, lorazepam, and diphenhydramine. Taking any of these drugs with venlafaxine may make the sleepiness from venlafaxine even worse.
  • Other drugs that can increase serotonin levels, such as fluoxetine, paroxetine, citalopram, duloxetine, lithium, and tramadol. Venlafaxine increases your levels of serotonin. Taking it with any of these drugs may increase your serotonin levels even more. If your serotonin levels are too high, a life threatening condition called serotonin syndrome can occur. Your doctor will monitor you closely when starting or increasing your dosage of either drug.
  • Certain drugs for migraine, called triptans, such as sumatriptan, rizatriptan, and zolmitriptan. Venlafaxine increases your levels of serotonin. Taking it with any of these drugs may increase your serotonin levels even more. If your serotonin levels are too high, a life threatening condition called serotonin syndrome can occur. Your doctor will monitor you closely when starting or increasing your dosage of either drug.

Interactions that can make your drugs less effective

When certain drugs are used with venlafaxine, they may not work as well. This is because the amount of these drugs in your body may be decreased. Examples of these drugs include:

  • Metoprolol. Metoprolol may be less effective when you take it with venlafaxine. This may cause your blood pressure to rise. Talk to your doctor before taking these drugs together.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Venlafaxine oral tablet comes with several warnings.

Allergy warning

Venlafaxine can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your face, tongue, eyes, or mouth
  • rash, hives, or blisters, alone or with joint paint or fever

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Alcohol interaction warning

Do not drink alcohol with venlafaxine. Drinking alcohol raises your risk of sleepiness from venlafaxine. This may affect your ability to make decisions, think clearly, and react quickly. If you drink alcohol, talk to your doctor.

Warnings for people with certain health conditions

For people with liver disease: If you have a history of liver disease, your liver may not process this drug as quickly as it should. This could lead to a buildup of this drug in your body. Your doctor may start you on a reduced dosage. If they increase your dosage later, they will monitor you closely.

For people with kidney disease: If you have kidney disease or a history of kidney disease, you may not be able to clear this drug from your body well. This may increase the levels of venlafaxine in your body. This can cause more side effects. Your doctor may start you on a low dosage and monitor you closely if they increase your dosage.

For people with heart problems: Venlafaxine can increase your heart rate, especially if you’re taking doses greater than 200 mg per day. If you have heart failure or if you’ve recently had a heart attack, your heart may not be able to tolerate this side effect.

For people with hyperthyroidism: Hyperthyroidism can increase your heart rate. Venlafaxine can also increase your heart rate. If you have hyperthyroidism and take venlafaxine, your heart rate may increase to a dangerous level. You are especially at risk if you take venlafaxine doses greater than 200 mg per day.

For people with a history of seizures: Venlafaxine raises your risk of seizures. If you have a seizure, stop taking venlafaxine and call your doctor right away.

For people with increased eye pressure (glaucoma): Venlafaxine can widen your pupils and block the flow of fluid in your eye. These effects can increase the pressure in your eyes. People with a history of increased eye pressure or glaucoma should have their eye pressure checked regularly while taking venlafaxine. Do not take venlafaxine if you have uncontrolled angle-closure glaucoma.

Warnings for other groups

For pregnant women: Venlafaxine is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or plan to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus. Call your doctor right away if you become pregnant while taking this drug.

For women who are breastfeeding: Venlafaxine may pass into breast milk and cause side effects in a child who is breastfed. Talk to your doctor about breastfeeding your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. Older adults may be at higher risk than younger people for low sodium levels in their blood when taking venlafaxine.

For children: This drug should not be used in people younger than 18 years of age.

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Forms and strengths

Generic: Venlafaxine

  • Form: immediate-release oral tablet
  • Strengths: 25 mg, 37. 5 mg, 50 mg, 75 mg, 100 mg
  • Form: extended-release oral tablet
  • Strengths: 37.5 mg, 75 mg, 150 mg, 225 mg

Dosage for depression

Adult dosage (ages 18 years and older)

  • Immediate-release oral tablets:
    • Typical starting dosage: 75 mg total per day, taken in two or three divided doses
    • Dosage increases: If needed, your doctor may increase your dosage to 150 mg per day.
    • Typical maximum dosage: 225 mg per day. If you have more severe depression, your doctor may prescribe a dosage as high as 375 mg per day, taken in three divided doses.
  • Extended-release oral tablets:
    • Typical starting dosage: 75 mg per day, taken in a single dose in the morning or evening. Some patients should start at a lower dosage of 37.5 mg per day for 4–7 days.
    • Dosage increases: If needed, your doctor may increase your dosage. They may increase it every 4 days by 75 mg until you reach 225 mg per day.
    • Typical maximum dosage: 225 mg per day.

Child dosage (ages 0–17 years)

This medication should not be used in people younger than 18 years of age.

Dosage for social anxiety disorder

Adult dosage (ages 18 years and older)

  • Extended-release oral tablets:
    • Typical dosage: 75 mg per day, given in a single dose in the morning or evening.
    • Maximum dosage: 75 mg per day.

Child dosage (ages 0–17 years)

This medication should not be used in people younger than 18 years of age.

Special dosage considerations

People with liver problems: People with mild to moderate liver problems should take about half of the typical dose. People with severe liver disease or cirrhosis may need an even lower dosage. Your doctor can tell you more.

People with kidney problems: People with mild to moderate kidney problems should take 75% of the typical dosage. People who are on dialysis should take half of the typical dosage. Your doctor can tell you more.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.

Venlafaxine oral tablet is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: Your depression or anxiety may not get better and may get worse. Do not stop venlafaxine without talking to your doctor. Stopping venlafaxine too quickly can cause serious symptoms such as:

  • anxiety
  • irritability
  • tiredness
  • restlessness
  • trouble sleeping
  • headache
  • sweating
  • dizziness
  • tingling or “pins and needles” feeling
  • shaking
  • confusion
  • nightmares
  • nausea
  • vomiting
  • diarrhea

If this happens, your doctor may have you start taking venlafaxine again and decrease your dosage slowly.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. This can lead to death. Symptoms of an overdose of this drug can include:

  • fast heart rate
  • unusual sleepiness
  • enlarged pupils
  • seizure
  • vomiting
  • heart rhythm changes
  • low blood pressure
  • muscle aches or pains
  • dizziness

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. If you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: The symptoms of your depression or anxiety should be less severe or happen less often.

Keep these considerations in mind if your doctor prescribes venlafaxine oral tablet for you.

General

  • Take venlafaxine with food.
  • You can cut or crush the immediate-release tablet, but do not cut or crush the extended-release tablet.

Storage

  • Store the immediate-release oral tablet at room temperature between 68°F and 77°F (20°C and 25°C).
  • Store the extended-release oral tablet at temperatures between 59°F and 86°F (15°C and 30°C).
  • Keep this drug away from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor may need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Mixed neurotransmitter reuptake inhibitorsMixed neurotransmitter reuptake inhibitors

Milnacipran

Milnacipran (ixel) is a serotonin and norepinephrine reuptake inhibitor, by virtue of its effect on two neurotransmitter systems, it avoids negative feedback at the level of somatodendrites and, thus, enhances the effect of the antidepressant (Romero L. , et al., 1996).

After taking the drug, its peak concentration in the blood is reached after 0.5-4 hours, a stable concentration after 2-3 days (when taking the drug twice a day. Cytochrome P450 2D6 is not involved in the metabolism of the drug, therefore it practically does not interact with other drugs. The half-life of milnacipran is approximately 8 hours.Adjustment of the dose of the drug should be carried out only in case of kidney disease.When co-administered with benzodiazepines, the concentration of drugs in the blood does not change, but when using carbamazepine, the level of milnacipran drops by 20%.The optimal daily dose of the drug corresponds to 100-200 mg It should be noted that the drug has a preventive effect in recurrent depression.0005

This drug is usually given as monotherapy. It is an antidepressant, comparable in its overall effectiveness to amitriptyline in the treatment of moderate depression, has a balanced stimulating and sedative effect, and the ability to normalize mood. Milnacipran (ixel) is characterized by a fairly early onset of a positive effect.

Side effects of milnacipran occur in up to 40% of patients, are usually mild, and are most commonly manifested by nausea, headache, and dysuria. The drug is preferred in the treatment of patients with mild to moderate depression on an outpatient basis.

Venlafaxine

Venlafaxine hydrochloride (effexor) is a selective serotonin, norepinephrine and dopamine reuptake inhibitor. This drug is about five times more active in relation to serotonin than to norepinephrine and is a weak inhibitor of dopamine reuptake.

In addition to the treatment of depression, the drug is recommended for the treatment of generalized anxiety disorder.

Venlafaxine is usually given at a daily dose of 75 mg, by mouth (in divided doses, for uncontrolled release, or as a single dose for controlled release formulations). Dose increases occur at intervals of 1-2 weeks (maximum daily dose - 375 mg. )

Venlafaxine is heavily exposed on first pass, its major metabolite, dysmethylvenlafaxine, is as potent as velafaxine itself. The half-life of the drug is 4 hours, the metabolite is 10 hours. At the same time, existing dosage forms of the substance with a controlled duration of action make it possible to prescribe venlafaxine once a day.

Side effects of the drug include: nausea, vomiting, anorexia, headache, lethargy, drowsiness, dizziness, increased sweating, sexual dysfunction, rash and lowering of blood pressure (at daily doses exceeding 225 mg, an increase in blood pressure is observed).

Back to Contents

Effexor XR Side Effects: What You Need to Know

Suicidal Thoughts and Behaviors in Children and Young People 24 years old). The boxed warning is the most serious warning from the Food and Drug Administration (FDA). It warns doctors and patients about drug side effects that can be dangerous.

It is important to note that Effexor XR is not approved for use in persons under 18 years of age.

See the Side Effects section below for more information.

Show more

Introduction

If you have certain mental illnesses, your doctor may suggest Effexor XR (venlafaxine) as a treatment option.

Effexor XR is a prescription drug used in adults to treat:

  • major depressive disorder
  • generalized anxiety disorder
  • social anxiety disorder
  • panic disorder

Effexor XR helps relieve the symptoms of these conditions. The drug comes in the form of capsules that you take by mouth once a day. If Effexor XR works for you, your doctor will likely recommend that you take it long term.

Effexor XR is an extended release (XR) formulation, which means that it releases the active ingredient slowly over an extended period of time.

For more information about Effexor XR, including its uses, see this detailed product article.

Like all medicines, Effexor XR can cause mild or serious side effects. Keep reading to find out more.

What are the most common side effects of Effexor XR?

Some people may experience mild or severe side effects while taking Effexor XR. Examples of commonly reported Effexor XR side effects include:

  • nausea
  • feeling tired
  • sweating*
  • constipation
  • sexual side effects

What are the mild side effects of Effexor XR?

Effexor XR may cause mild side effects in some people. Examples of mild side effects that have been reported with Effexor XR include:

  • Nausea
  • Feeliness Feelings
  • Slicks*
    • Card
  • Sexual side effects
  • Dry Dry
  • Unusual dreams
    • STOM * To learn more about this side effect, see "Explanation of Side Effects" below.

    In most cases, these side effects should be temporary. And some are easy to deal with. But if you have any symptoms that continue or bother you, talk to your doctor or pharmacist. And don't stop using Effexor XR unless your doctor recommends it.

    Effexor XR may cause mild side effects other than those listed above. See the Effexor XR Treatment Guide for details.

    After the Food and Drug Administration (FDA) approves a drug, it monitors the drug's side effects. If you would like to notify the FDA of a side effect you have had with Effexor XR, please visit MedWatch.

    What are the serious side effects of Effexor XR?

    In rare cases, some people may develop serious side effects from taking Effexor XR. Serious side effects reported with Effexor XR include:

    • suicidal thoughts or behavior*
    • serotonin syndrome
    • high blood pressure†
    • unusual bleeding
    • eye problems such as angle-closure glaucoma 9045 hypomania
    • allergic reaction †‡
    • low blood sodium
    • seizures
    • lung problems such as pneumonia
    • high cholesterol

    Call your doctor right away if you develop serious side effects while taking Effexor XR. If the side effects seem life-threatening or if you think you need a medical emergency, call 911 or your local emergency number right away.

    * Effexor XR has a boxed warningA reliable source for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see See the "Explanation of Side Effects" section below.
    † To learn more about this side effect, see "Explanation of Side Effects" below.
    ‡ An allergic reaction may occur after using Effexor XR. But it is not clear if this side effect occurred in studies.

    Frequently Asked Questions About Effexor XR Side Effects

    Get answers to some frequently asked questions about Effexor XR side effects.

    Does my risk of side effects increase in the first week of taking Effexor XR?

    It is possible. In the first week of treatment with Effexor XR, you may experience more side effects. But not everyone will experience side effects, and side effects can be different for each person.

    When you first start taking a new drug, your body needs to get used to it. Thus, you may experience more side effects in the first week. It takes about 3 days for Effexor XR to reach a constant blood level. During this time, as your body adjusts, you may be at a higher risk of side effects.

    The side effects you experience may also depend on your other medical conditions or other medicines you are taking. If you have questions about what to expect when you first start taking Effexor XR, talk to your doctor or pharmacist.

    Are there any long-term side effects of Effexor XR?

    Yes, long-term side effects of Effexor XR are possible. Examples include weight gain, weight loss, and eye problems such as angle-closure glaucoma.

    It is possible that taking Effexor XR for a longer period of time may increase the risk of long-term side effects. But this is not the case for everyone, as Effexor XR side effects can vary from person to person.

    If you are concerned about the long-term side effects of Effexor XR, talk to your doctor or pharmacist.

    Do the side effects of Effexor XR change depending on the dose I take (37.5 mg, 75 mg or 150 mg)?

    It is possible. You may be at an increased risk of side effects if you take a higher dose of Effexor XR. This is because there are more drugs in your body and they can have a greater effect on you.

    Effexor XR is available in 37.5 mg, 75 mg and 150 mg. In most cases, the maximum recommended dose of Effexor XR is 225 mg per day. In some cases, a doctor may prescribe a dose of up to 300 mg per day. But this is not an FDA-approved dose.

    You should always take the dosage prescribed by your doctor. They will determine the best dosage for your needs.

    If you experience side effects from Effexor XR, talk to your doctor. They may want to lower your dose to see if it helps reduce your side effects.

    Can side effects occur if I miss or stop taking Effexor XR?

    Yes, it is possible that skipping a dose of Effexor XR or stopping treatment abruptly could cause certain side effects.

    In particular, abrupt discontinuation of treatment may lead to a withdrawal syndrome. Examples of the symptoms of the cancellation that may occur if you stop taking Effexor XR, include:

    • Excitement or irritability
    • Confusion
    • Anxiety
    • Headache
    • insomnia (sleep problems)
      • 9004 seizures 4 If you miss a dose of Effexor XR, take it as soon as you remember. But if it's almost time for your next dose, skip the missed dose and take your next dose as usual. You should not take two doses of Effexor XR to make up for a missed dose. This may increase the risk of side effects.

      If you are interested in stopping your Effexor XR treatment, talk to your doctor first. They will likely want to gradually reduce your dose so that you do not experience withdrawal symptoms.

      In most cases, your doctor will decrease your dose by 75 milligrams per week until you stop taking the drug. But be sure to follow your doctor's advice to reduce the dose and stop treatment.

      Because some withdrawal symptoms can be severe, you should not stop taking Effexor XR without first talking to your doctor. They can help you safely stop treatment.

      How long do Effexor XR side effects last?

      It depends. Some side effects, such as nausea, may occur when you first start taking Effexor XR, but may go away after a while. Other side effects, including decreased appetite and weight changes, may persist throughout treatment.

      If you are concerned about certain side effects of Effexor XR, talk to your doctor. They can discuss your risk for these side effects and how long they may last if you experience them. Your doctor can also treat your side effects so they don't last as long.

      Side effects explained

      Find out more about some of the side effects Effexor XR may cause.

      Weight gain or weight loss

      Weight gain or loss may occur in people taking Effexor XR. But these were not the common side effects reported in the Effexor XR studies.

      What can help

      If you are concerned about any unexpected weight gain or loss you experience while taking Effexor XR, talk to your doctor. They can help determine what your next steps should be.

      Sweating

      You may sweat during treatment with Effexor XR. Sweating was one of the most common side effects reported in studies by people taking Effexor XR.

      What can help

      If you're sweating more than usual while taking Effexor XR and it's bothering you, talk to your doctor. They may be able to recommend ways to reduce this side effect. In some cases, they may recommend another medication to treat your mental condition.

      Suicidal ideation and behavior in children and young people

      Effexor XR has a warning about the risk of suicidal ideation and behavior in children and young people (aged 18 to 24 years). The boxed warning is the most serious warning from the Food and Drug Administration (FDA). It warns doctors and patients about drug side effects that can be dangerous.

      All antidepressants contain this warning about suicidal thoughts and behavior. These side effects may occur during the first few months after starting treatment or with each dose increase or decrease.

      It is important to note that Effexor XR is not approved for use in persons under 18 years of age.

      What can help

      It is important that you tell your doctor if you notice any new or worsening symptoms of depression or suicidal thoughts or behavior. These may include:

      • suicidal thoughts or suicide attempts
      • violence or aggression
      • anxiety or panic attacks
      • feeling restless or irritable
      • insomnia (sleep problems)
      • changes in behavior or mood

      Also tell your doctor if you notice any problems with your eyes. These may include:

      • changes in your vision
      • eye pain
      • redness or swelling in or around the eye

      If you notice any of these symptoms, talk to your doctor. If the side effects seem life-threatening or if you think you need emergency medical attention, call 9 right away11 or your local emergency number.

      If you are a young person taking Effexor XR, your doctor will likely monitor you more closely during treatment for any symptoms of depression and suicidal thoughts or behavior.

      SUICIDE PREVENTION

      If you think someone is at immediate risk of harming themselves or harming another person:

      • Call 911 or your local emergency number.
      • Stay with the person until help arrives.
      • Remove all weapons, knives, medicines, and other items that could cause harm.
      • Listen, but don't judge, argue, threaten or yell.

      If you or someone you know is thinking about suicide, get help from a crisis or suicide prevention hotline. Call the National Suicide Prevention Hotline at 800-273-8255.

      High blood pressure

      Effexor may increase blood pressure. In clinical studies, some people who did not already have high blood pressure developed the condition after starting treatment with Effexor XR.

      If you already have high blood pressure, Effexor XR may make it worse.

      What can help

      Before you start taking Effexor XR, tell your doctor about any blood pressure problems you have or if you are taking blood pressure medication.

      If you have untreated high blood pressure, your doctor will likely want to treat it before starting treatment with Effexor XR. This is because the drug can also increase blood pressure, which may not be safe if your blood pressure is already high.

      Your doctor will also check and monitor your blood pressure throughout your treatment.

      Allergic reaction

      Like most medicines, Effexor XR may cause an allergic reaction in some people. But it is not clear if this side effect occurred in studies.

      Symptoms may be mild or severe and may include:

      • skin rash
      • itching
      • redness (temporary fever, redness, or discoloration of the skin)
      • swelling under the skin, usually on the eyelids, lips, hands, or legs
      • swelling of the mouth, tongue, or throat, which can make breathing difficult
      What can help

      If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an over-the-counter oral antihistamine such as Benadryl (diphenhydramine) or a topical product such as hydrocortisone cream to relieve your symptoms.

      If your doctor confirms that you had a mild allergic reaction to Effexor XR, they will decide whether you should continue using it.

      If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms can be life threatening and require immediate medical attention.

      If your doctor confirms that you have had a serious allergic reaction to Effexor XR, he may ask you to switch to another treatment.

      Tracking side effects

      Consider keeping a record of any side effects you experience during your treatment with Effexor XR. You can then share this information with your doctor. This is especially helpful when you first start taking new medications or using a combination of treatments.

      Your side effect notes may include things like:

      • what dose of the drug you were taking when you had the side effect
      • How soon after starting this dose did you experience a side effect
      • What were your symptoms due to the side effect
      • How did it affect your daily activities
      • What other medications did you also take
      • Any other information you think important

      Taking notes and sharing them with your doctor will help him learn more about how the drug is affecting you. Your doctor may use this information to adjust your treatment plan if necessary.

      Effexor XR Warnings

      Before you start taking Effexor XR, talk to your doctor about any medical conditions you have or any medications you are taking. They can determine if this medicine might be a safe treatment option for you.

      Detailed warnings for this drug are listed below.

      Boxed Warning: Suicidal Thoughts and Behaviors in Children and Young Adults

      Effexor XR has a boxed warning A trusted source for suicidal thoughts and behaviors in children and young adults (aged 18 to 24 years). The boxed warning is the most serious warning from the Food and Drug Administration (FDA). It warns doctors and patients about drug side effects that can be dangerous.

      If you are a young person taking Effexor XR, your doctor will likely monitor you more closely during treatment for any symptoms of depression and suicidal thoughts or behavior.

      It is important to note that Effexor XR is not approved for use in persons under 18 years of age.

      For more information see . see the "Explanation of Side Effects" section above.

      Other Warnings

      Effexor XR may not be right for you if you have certain medical conditions or other health conditions. Talk to your doctor about your medical history before taking Effexor XR. The list below includes factors to consider.

      High blood pressure or other heart problems. Tell your doctor if you have high blood pressure before taking Effexor XR. This drug can cause an even higher increase in blood pressure. Your doctor will check your blood pressure before you start treatment. If this is not well managed, your doctor will likely recommend treating your high blood pressure before you start taking Effexor XR. Even if your blood pressure is well controlled, your doctor may want to monitor you more closely during your treatment with Effexor XR. This is to ensure that your blood pressure does not get too high.

      Allergic reaction. If you have had an allergic reaction to Effexor XR or any of its ingredients, you should not take Effexor XR. Ask your doctor which other medicines are best for you.

      Bipolar disorder or mania. Effexor XR may aggravate the symptoms of bipolar disorder or mania. If you have one of these conditions, your doctor may recommend a different medication to treat your condition, or may monitor you more closely during treatment.

      Glaucoma. Effexor XR can cause an eye condition called angle-closure glaucoma. If you already have angle-closure glaucoma, Effexor XR may make your condition worse. Talk to your doctor about any eye conditions you have before taking Effexor XR.

      Liver problems. Effexor XR may cause an increase in liver enzymes, which may be a sign of liver disease. If you already have liver problems, Effexor XR may make your condition worse. Before starting treatment with Effexor XR, tell your doctor about any liver disease you have.

      Kidney problems. Effexor XR is eliminated from the body through the kidneys. If your kidneys are not working properly, your body will not be able to get rid of the drug as quickly as it should. This can cause levels of the drug to build up in the body, which can increase the risk of side effects. If you have any kidney problems, talk to your doctor before taking Effexor XR. They can determine if it is safe for you to take this drug.

      Convulsions or convulsions. Effexor XR may increase the risk of seizures. If you have seizures or have had seizures or seizures before, Effexor XR may further increase your risk of seizures. Talk to your doctor about whether it is safe for you to take Effexor XR.

      Low blood sodium. Effexor XR may decrease the amount of sodium in your blood. If you already have low sodium, this can be dangerous. Low sodium levels can cause confusion, fatigue, seizures, and even coma. If you have low blood sodium levels, or have already had one, tell your doctor before taking Effexor XR.

      High cholesterol. Effexor XR may cause an increase in cholesterol levels. If you already have high cholesterol, this medication may make it worse. Talk to your doctor to see if this drug is right for you.

      Bleeding problems. Effexor XR may increase the risk of bleeding. If you have any medical conditions that can also cause bleeding problems, or if you are taking medications that can affect your blood, tell your doctor before taking Effexor XR. They may recommend a different medication for you, or they may monitor you more closely throughout your treatment.

      Drinking alcohol and Effexor XR

      You should not drink alcohol while taking Effexor XR. Alcohol may increase the risk of some side effects from Effexor XR.

      If you have concerns about not drinking alcohol while taking Effexor XR, talk to your doctor.

      Pregnancy and breastfeeding while taking Effexor XR

      Below are the details of using Effexor XR while pregnant or breastfeeding.

      Pregnancy

      It is not known if it is safe to take Effexor XR during pregnancy. If you are pregnant or planning to become pregnant, talk to your doctor before taking Effexor XR.

      Breastfeeding

      Effexor XR is not recommended while breastfeeding. Effexor XR passes into breast milk and may affect a nursing baby. If you are currently breastfeeding or planning to breastfeed, talk to your doctor about your options.

      What to ask your doctor

      Effexor XR may be an effective treatment for certain mental illnesses. But some people may experience side effects when taking this drug. Most side effects are mild, but some can be serious.

      Before taking Effexor XR, it is important to discuss possible side effects with your doctor so you know what to look out for. Here are some questions you can ask your doctor:

      • How do I treat any side effects I experience?
      • Do I have an increased risk of side effects due to my other medical conditions?
      • What should I do if I get pregnant while taking Effexor XR?

      Consider subscribing to an anxiety and depression newsletter if you are taking Effexor XR for any of these conditions.

      Ask a pharmacist

      Question:

      If I am taking a monoamine oxidase inhibitor (MAOI), how long do I have to wait between stopping the MAOI and starting treatment with Effexor XR before I have side effects?

      Patient Anonymous

      A:

      A: If you are taking Effexor XR along with an MAOI such as the antidepressant Nardil (phenelzine) or the antibiotic Zyvox (linezolid), you should not take these medicines for 7 days after stopping Effexor XR unless recommended by a doctor. It is also important that you stop taking MAOIs at least 2 weeks before starting Effexor XR treatment.

      Always talk to your doctor before stopping any medication.

      Melissa Badowski, PharmD, MPH, FCCP Answers represent the views of our medical experts. All content is for informational purposes only and should not be considered medical advice.

      Disclaimer. The Company has made every effort to ensure that all information is accurate, complete and up to date. However, this article should not be used as a substitute for the knowledge and experience of a licensed healthcare professional. You should always check with your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or side effects. The absence of warnings or other information for a given medicinal product does not mean that the drug or combination of drugs is safe, effective, or suitable for all patients or for all specific uses.

      Learn more